MATERNAL MORBIDITY IN EMERGENCY VERSUS ELECTIVE CAESAREAN SECTION AT TERTIARY CARE HOSPITAL
AbstractBackground: In the past 30 years the rate of caesarean section (C/S) has steadily increased from 5% tomore than 20% for many avoidable and unavoidable indications. The objective of this study was tocompare maternal morbidity and determine its cause in elective and emergency caesarean section.Method: It was a cross-sectional comparative study conducted in Civil Hospital Karachi at Obs/GynUnit III. All mothers admitted through OPD or emergency during the study period, of any age or parityundergoing C/S were recruited in the study. Patients having previous myomectomy, hysterotomy orclassical C/S were excluded from the study. Patients undergoing emergency C/S were placed in group A,and those delivered by elective C/S were included in group B. Study variables were general and obstetricparameters and complications observed intra-operatively. Any postoperative complications wererecorded from recovery room till patient was discharged from the ward. Results: There were 50 patientsin each group. In group A, 11 (22%) were booked and 33 (66%) were referred cases. In group B, 48(96%) were booked. The mean age in both groups was 28 years. In both groups, multigravida comparedto primigravida were 78% vs 22% in group A, and 92% vs 8% in group B. Indication for C/S wasprevious C/S in 10 (20%) patients in group A, and 39 (78%) patients in group B, placenta previa,chorioamionitis, obstructed labour (6, 12% each); pregnancy induced hypertension and eclampsia in 5(10%) cases in group A only. Intra-operative complications in group A were 48 (96%) vs 15 (30%) ingroup B (p=0.000). Postoperative morbidity in group A was 50 (100%) and 26 (52%) in group B(p=0.000). Intra-operative complication was haemorrhage in 46 (92%) cases in group A and 11 (22%) ingroup B. Anaesthetic complications were 40 (80%); prolonged intubation 25 (50%), aspiration of gastriccontents 8 (16%), and difficult intubation 7 (14%) in group A. Ten (20%) cases had anaestheticcomplications in group B. Commonest postoperative complication in both groups was anaemia in 41(82%) and 11 (22%) cases respectively. Conclusion: Maternal morbidity is significantly higher inemergency C/S. Haemorrhage is a frequent complication in C/S, emergency or elective.Keywords: Emergency C/S, Elective C/S, Maternal, Caesarean Section, Morbidity and Mortality
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